Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

Lower Pole UPJ Obstruction in a Bifid Ureter

A girl at about age 6 began to have left-sided pain that was quite debilitating. IVP (Figure 1) showed left lower pole hydronephrosis. VCUG was normal. A retrograde ureterogram (Figure 2) showed a left bifid ureter with the bifurcation at about the junction of the upper third and the lower two thirds of the ureter. There was UPJ obstruction of the lower pole. She underwent left lower-to-upper pyeloureterostomy (Figure 3).